New onset of heterophilic antibody interference in prostate-specific antigen measurement occurring during the period of post-prostatectomy prostate-specific antigen monitoring

This version was published on 1 May 2009

Ann Clin Biochem 2009;46:253-256
© 2009 Association for Clinical Biochemistry


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Case Reports

B E Fritz1,
R J Hauke2 and
D F Stickle1

1 Department of Pathology and Microbiology;
2 Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA

Corresponding author: Dr D F Stickle. Email: dstickle{at}

Laboratories evaluated whether an interference was causing a false-positive PSA for the Immulite 2000 immunoassay after a time course of increasing prostate-specific antigen (PSA) in a post-prostatectomy patient led to salvage therapy, which had no effect on the elevated PSA. Serial dilutions of PSA for the patient sample (6.1 ng/mL; post-prostatectomy reference range: <0.1 ng/mL [undetectable]) were linear (r > 0.99). However,the PSA measurement was reduced to 0.1 ng/mL after pretreatmentof the sample with heterophilic antibody blocking reagent. PSAwas undetectable (<0.1 ng/mL) when measured using two alternativeimmunoassays. These results were consistent with the presenceof heterophilic antibody interference for the Immulite 2000assay. In this case, heterophilic antibody interference withPSA measurement must have originated during the period of post-prostatectomymonitoring, and the apparent progressive increases in PSA mayhave been due solely to the progressive increase of this heterophilicantibody assay interference. In the absence of clinical correlation,positive PSA monitoring results should always be assessed forheterophilic antibody interference for at least one time point.

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